Journal of the Royal Naval Medical Service
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Musculoskeletal pain is a common presentation in military patients. If not managed effectively it can have a detrimental effect on both the individual and the ship/unit. This article aims to examine how to thoroughly assess a military patient presenting with acute musculoskeletal pain; to provide the practitioner with a framework for effective pain history taking, and to help identify and exclude rare but serious causes of pain - 'red and yellow flag concepts'. Key management steps and appropriate interventions for managing acute, benign musculoskeletal pain are discussed and related to the varying environmients where the patient may be encountered.
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Due to the nature of IED injuries, during the conflicts in Iraq and Afghanistan The traditional, two-stage amputation for unsalvageable combat lower limb injuries has evolved into a strategy of serial debridement and greater use of plastic surgical techniques in order to preserve residual limb length. This study aimed to characterise the current treatment of lower limb loss with particular focus on the impact of specific wound infections. ⋯ A final more proximal amputation level was required in 21 stumps (30%). Recovery of A. hydrophillia from wounds was significantly associated with a requirement for a more proximal amputation level (p=0.0038) and greater number of debridements (p=0.0474) when compared to residual limb wounds withoutA. hydrophillia.
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Surgical trauma care on operations is delivered by consultants. The DMS presently delivers training to surgeons to enable them to deliver this care as newly-qualified consultants. Deploying as a trainee is one of many training evolutions available to achieve this competency. This paper describes the process involved in trainees deploying, and the training received by the first author (CAF) during a recent deployment. ⋯ Deploying on operations as a trainee is invaluable in preparing DMS juniors for their future roles as consultants in the DMS. Training is received not only in a breadth of surgical and resuscitative procedures, beyond a trainee's "base specialty", but also in other critical aspects of deployments including Crew Resource Management.